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1.
J Spec Oper Med ; 22(3): 104-107, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-35877979

RESUMO

Since 2016, there has been an increase in reported cases of intelligence officers and diplomats hearing pulsing sounds and experiencing neurophysiologic and cognitive symptoms. These varied and often intense symptoms manifest in ways similar to a traumatic brain injury (TBI) but without inciting trauma. Known formerly as "unconventionally acquired brain injury" (UBI), these events are now labeled "anomalous health incidents" (AHIs). Investigations of these incidents suggest reasons to be concerned that a specific type of neuroweapon may be the cause-a directed energy weapon (DEW). Neuroweapons that target the brain to influence cognition and behavior are leading to a new domain of warfare-neurowarfare. The implications and resultant stakes, especially for the Special Operations community, are significant. This article focuses specifically on the implications of DEWs as a neuroweapon causing UBIs/AHIs for military medical practitioners and suggests using a comprehensive strategy, analogous to that of chemical warfare or other weapons of mass destruction (WMD), to improve our preparedness for the medical repercussions of neurowarfare.


Assuntos
Guerra Química , Medicina Militar , Militares , Humanos , Guerra
2.
J Spec Oper Med ; 22(1): 9, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35278311
3.
J Trauma Acute Care Surg ; 91(4): e104-e113, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34238862

RESUMO

ABSTRACT: Endovascular resuscitation is an emerging area in the resuscitation of both severe traumatic hemorrhage and nontraumatic cardiac arrest. Vascular access is the critical first procedural step that must be accomplished to initiate endovascular resuscitation. The endovascular interventions presently available and emerging are routinely or potentially performed via the femoral vessels. This may require either femoral arterial access alone or access to both the femoral artery and vein. The time-critical nature of resuscitation necessitates that medical specialists performing endovascular resuscitation be well-trained in vascular access techniques. Keen knowledge of femoral vascular anatomy and skill with vascular access techniques are required to meet the needs of critically ill patients for whom endovascular resuscitation can prove lifesaving. This review article addresses the critical importance of femoral vascular access in endovascular resuscitation, focusing on the pertinent femoral vascular anatomy and technical aspects of ultrasound-guided percutaneous vascular access and femoral vessel cutdown that may prove helpful for successful endovascular resuscitation.


Assuntos
Procedimentos Endovasculares/métodos , Parada Cardíaca/terapia , Hemorragia/terapia , Ressuscitação/métodos , Ferimentos e Lesões/complicações , Artéria Femoral/cirurgia , Hemorragia/diagnóstico , Hemorragia/etiologia , Humanos , Índice de Gravidade de Doença , Ferimentos e Lesões/terapia
4.
J Spec Oper Med ; 21(1): 87-89, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33721312

RESUMO

Ultrasonography is currently the primary means of imaging for forward surgical teams/forward resuscitative surgical teams (FSTs/FRSTs). As FSTs/FRSTs are pushed farther forward into more austere environments, access to other imaging modalities may be limited, potentially affecting resources. On a recent deployment, the 126th FRST was able to use radiography equipment from a co-located explosive ordnance disposal (EOD) team to assist in the diagnosis and treatment of medical and surgical patients, thereby saving time and resources. We provide three case examples in which using EOD radiography assisted in clinical decision making. Although the safety profile has not been assessed for clinical use in humans, EOD radiography can be a useful technique to aid in time-sensitive decision making in resource-constrained operational areas.


Assuntos
Substâncias Explosivas , Humanos , Radiografia , Ressuscitação , Ultrassonografia
7.
Am J Emerg Med ; 36(6): 1121.e5-1121.e6, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29540284

RESUMO

Use of Resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of non-compressible hemorrhage is a re-emerging technology that historically is employed by surgeons. We present a case in which REBOA was successfully placed by an emergency physician in a critical mass casualty patient awaiting transfer to the operating table. This case is an example in which emergency physicians, in collaboration with the surgeon, can utilize REBOA to temporize non-compressible hemorrhage when a surgeon is not immediately available.


Assuntos
Traumatismos Abdominais/terapia , Oclusão com Balão/métodos , Procedimentos Endovasculares/métodos , Ressuscitação , Choque Hemorrágico/terapia , Ferimentos por Arma de Fogo/terapia , Traumatismos Abdominais/fisiopatologia , Oclusão com Balão/instrumentação , Transfusão de Sangue , Hemodinâmica , Humanos , Masculino , Ressuscitação/instrumentação , Ressuscitação/métodos , Choque Hemorrágico/fisiopatologia , Tempo para o Tratamento , Resultado do Tratamento , Ferimentos por Arma de Fogo/fisiopatologia , Adulto Jovem
8.
J Spec Oper Med ; 18(1): 70-73, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29533436

RESUMO

Effective analgesia is a crucial part of the care and resuscitation of a traumatically injured patient. These secondary effects of pain may increase morbidity and mortality in the acutely injured patient. When ketamine is administered appropriately in the clinical setting, it can provide analgesia, anxiolysis, and amnesia for patients with less respiratory depression and hypotension than equivalent doses of opioid analgesics.


Assuntos
Analgésicos/uso terapêutico , Ketamina/uso terapêutico , Medicina Militar/normas , Militares , Dor/tratamento farmacológico , Adulto , Campanha Afegã de 2001- , Analgésicos/efeitos adversos , Auxiliares de Emergência , Humanos , Ketamina/efeitos adversos , Masculino , Dor/etiologia , Melhoria de Qualidade , Estados Unidos , Lesões Relacionadas à Guerra/complicações , Adulto Jovem
9.
Ann Emerg Med ; 69(2): 253-254, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28126122
11.
J Spec Oper Med ; 15(2): 1-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26125158

RESUMO

Motion sickness can be a limiting factor for sea and air missions. We report the experience of a Pararescue (PJ) team on a Pacific Ocean rescue mission in which motion sickness was prevalent. Cinnarizine, an antagonist of H1-histamine receptors, was used to treat affected PJs. We also report findings of a survey of PJs regarding motion sickness. A family of four on a disabled sailboat 900 miles off the coast of Mexico sent out a distress call because their 1-year-old daughter became severely ill with fever and diarrhea. Four PJs were deployed on a C-130, performed a free-fall parachute insertion into the ocean, and boarded the sailboat. All four PJs experienced onset of motion sickness at some point during the early part of the mission and symptoms persisted through the first 24 hours. Three PJs experienced ongoing nausea, vomiting, dizziness, and sensory imbalances. The captain of the sailboat offered the three sick PJs approximately 18mg of cinnarizine two or three times a day with relief of symptoms and improvement on operational effectiveness. A new, anonymous, voluntary survey of Air National Guard PJs and combat rescue officers revealed that 78.4% of Operators have experienced motion sickness at sea. We discuss the current theories on motion sickness, the effect of motion sickness on operational effectiveness, and research on treatment of motion sickness, including the medication cinnarizine.


Assuntos
Cinarizina/uso terapêutico , Socorristas , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Enjoo devido ao Movimento/tratamento farmacológico , Aeronaves , Humanos , Masculino , Medicina Militar , Navios
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